Connelley, Jon R

Connelley, Jon R is an individual health care provider with primary practice located at 624 Hospital Drive Suite 503, Mountain Home AR 72653-2955. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Connelley, Jon R can be contacted via phone (870) 508-1000.

Contact Information

Primary practice address
624 Hospital Drive Suite 503 Mountain Home AR 72653-2955
Phone: (870) 508-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X C-8366 Arkansas

Profile Details

NPI number 1538246202
LBN Legal business name Connelley, Jon R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Apr 15th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538246202 NPPES
Oklahoma MEDICAID 100081120B
Oklahoma MEDICAID 130416001
Oklahoma MEDICAID 126543001

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